<include file="Public/header" />
<div class="row">
    <div class="col-md-8 col-md-offset-2">
        <img src="__PUBLIC__/file/{$system['logo']}" style="padding: 2rem;"/>
        <div class="panel panel-default">
            <div class="panel-heading">
                <h3 class="panel-title">欢迎旅社加盟，请填写以下申请信息</h3>
            </div>
            <div class="panel-body">
                <form class="form-horizontal" role="form" method="post" enctype="multipart/form-data" style="padding-left: 10px;padding-right: 10px;">
                    <div class="form-group">
                        <label class="col-xs-12 col-sm-3 col-md-3 control-label no-padding-right" for="username"> 手机号 </label>
                        <div class="col-xs-12 col-sm-6">
                            <span class="block input-icon input-icon-right">
                        <input type="text" class="width-100" placeholder="手机号" id="username" name="username"  value="{$model['username']|default=''}" validate-required="required:请填写手机号" <if condition="ACTION_NAME eq update">readonly</if>/>
                        <i class=""></i>
                    </span>
                        </div>
                        <div class="help-block col-xs-12 col-sm-reset inline" style="margin-bottom: 5px;"></div>
                    </div>
                    <div class="form-group">
                        <label class="col-xs-12 col-sm-3 col-md-3 control-label no-padding-right" for="password"> 密码 </label>
                        <div class="col-xs-12 col-sm-6">
                            <span class="block input-icon input-icon-right">
                        <input type="password" class="width-100" placeholder="密码" id="password" name="password"  value="{$model['password']|default=''}" validate-required="required:请填写密码" />
                        <i class=""></i>
                    </span>
                        </div>
                        <div class="help-block col-xs-12 col-sm-reset inline" style="margin-bottom: 5px;"></div>
                    </div>
                    <div class="form-group">
                        <label class="col-xs-12 col-sm-3 col-md-3 control-label no-padding-right" for="repassword"> 重复密码 </label>
                        <div class="col-xs-12 col-sm-6">
                            <span class="block input-icon input-icon-right">
                        <input type="password" class="width-100" placeholder="密码" id="password" name="repassword"  value="{$model['repassword']|default=''}" validate-required="required:请填写密码" />
                        <i class=""></i>
                    </span>
                        </div>
                        <div class="help-block col-xs-12 col-sm-reset inline" style="margin-bottom: 5px;"></div>
                    </div>
                    <input type="hidden" name="type" value="旅社" />
                    <input type="hidden" name="state" value="禁用" />
                    <div class="form-group">
                        <label class="col-xs-12 col-sm-3 col-md-3 control-label no-padding-right" for="name"> 姓名 </label>
                        <div class="col-xs-12 col-sm-6">
                            <span class="block input-icon input-icon-right">
                        <input type="text" class="width-100" placeholder="姓名" id="name" name="name"  value="{$model['name']|default=''}" validate-required="required:请填写姓名" />
                        <i class=""></i>
                    </span>
                        </div>
                        <div class="help-block col-xs-12 col-sm-reset inline" style="margin-bottom: 5px;"></div>
                    </div>
                    <div class="form-group">
                        <label class="col-xs-12 col-sm-3 col-md-3 control-label no-padding-right" for="photo"> 头像 </label>
                        <div class="col-xs-12 col-sm-6">
                            <span class="block input-icon input-icon-right">
                        <input type="file" class="width-100" placeholder="头像" id="photo" name="photo"  value="{$model['photo']|default=''}"  validate-required="required:请选择头像"/>
                        <i class=""></i>
                    </span>
                        </div>
                        <div class="help-block col-xs-12 col-sm-reset inline" style="margin-bottom: 5px;"></div>
                    </div>
                    <div class="form-group">
                        <label class="col-xs-12 col-sm-3 col-md-3 control-label no-padding-right" for="location"> 所在地 </label>
                        <div class="col-xs-12 col-sm-6">
                            <span class="block input-icon input-icon-right">
                        <input type="text" class="width-100" placeholder="所在地" id="location" name="location"  value="{$model['location']|default=''}"  />
                        <i class=""></i>
                    </span>
                        </div>
                        <div class="help-block col-xs-12 col-sm-reset inline" style="margin-bottom: 5px;"></div>
                    </div>
                    <div class="form-group">
                        <label class="col-xs-12 col-sm-3 col-md-3 control-label no-padding-right" for="id_number"> 身份证号 </label>
                        <div class="col-xs-12 col-sm-6">
                            <span class="block input-icon input-icon-right">
                        <input type="text" class="width-100" placeholder="身份证号" id="id_number" name="id_number"  value="{$model['id_number']|default=''}"  />
                        <i class=""></i>
                    </span>
                        </div>
                        <div class="help-block col-xs-12 col-sm-reset inline" style="margin-bottom: 5px;"></div>
                    </div>
                    <div class="form-group">
                        <label class="col-xs-12 col-sm-3 col-md-3 control-label no-padding-right" for="birthday"> 生日 </label>
                        <div class="col-xs-12 col-sm-6">
                            <span class="block input-icon input-icon-right">
                        <input type="text" class="width-100" placeholder="生日" id="birthday" name="birthday"  value="{$model['birthday']|default=''|date='Y-m-d',###}"  onClick="WdatePicker()" readonly=""/>
                        <i class=""></i>
                    </span>
                        </div>
                        <div class="help-block col-xs-12 col-sm-reset inline" style="margin-bottom: 5px;"></div>
                    </div>
                    <div class="form-group">
                        <label class="col-xs-12 col-sm-3 col-md-3 control-label no-padding-right" for="email"> 邮箱 </label>
                        <div class="col-xs-12 col-sm-6">
                            <span class="block input-icon input-icon-right">
                        <input type="text" class="width-100" placeholder="邮箱" id="email" name="email"  value="{$model['email']|default=''}"  />
                        <i class=""></i>
                    </span>
                        </div>
                        <div class="help-block col-xs-12 col-sm-reset inline" style="margin-bottom: 5px;"></div>
                    </div>
                    <div class="form-group">
                        <label class="col-xs-12 col-sm-3 col-md-3 control-label no-padding-right" for="bank"> 银行 </label>
                        <div class="col-xs-12 col-sm-6">
                            <span class="block input-icon input-icon-right">
                        <input type="text" class="width-100" placeholder="银行" id="bank" name="bank"  value="{$model['bank']|default=''}"  />
                        <i class=""></i>
                    </span>
                        </div>
                        <div class="help-block col-xs-12 col-sm-reset inline" style="margin-bottom: 5px;"></div>
                    </div>
                    <div class="form-group">
                        <label class="col-xs-12 col-sm-3 col-md-3 control-label no-padding-right" for="card_no"> 银行卡号 </label>
                        <div class="col-xs-12 col-sm-6">
                            <span class="block input-icon input-icon-right">
                        <input type="text" class="width-100" placeholder="银行卡号" id="card_no" name="card_no"  value="{$model['card_no']|default=''}"  />
                        <i class=""></i>
                    </span>
                        </div>
                        <div class="help-block col-xs-12 col-sm-reset inline" style="margin-bottom: 5px;"></div>
                    </div>
                    <div class="form-group">
                        <label class="col-xs-12 col-sm-3 col-md-3 control-label no-padding-right" for="club_name"> 旅行社名称 </label>
                        <div class="col-xs-12 col-sm-6">
                            <span class="block input-icon input-icon-right">
                        <input type="text" class="width-100" placeholder="旅行社名称" id="club_name" name="club_name"  value="{$model['club_name']|default=''}" validate-required="required:请填写旅行社名称" />
                        <i class=""></i>
                    </span>
                        </div>
                        <div class="help-block col-xs-12 col-sm-reset inline" style="margin-bottom: 5px;"></div>
                    </div>
                    <div class="form-group">
                        <label class="col-xs-12 col-sm-3 col-md-3 control-label no-padding-right" for="address"> 旅行社地址 </label>
                        <div class="col-xs-12 col-sm-6">
                            <span class="block input-icon input-icon-right">
                        <input type="text" class="width-100" placeholder="旅行社地址" id="address" name="address"  value="{$model['address']|default=''}" validate-required="required:请填写旅行社地址" />
                        <i class=""></i>
                    </span>
                        </div>
                        <div class="help-block col-xs-12 col-sm-reset inline" style="margin-bottom: 5px;"></div>
                    </div>
                    <div class="form-group">
                        <label class="col-xs-12 col-sm-3 col-md-3 control-label no-padding-right" for="service_area"> 服务地区 </label>
                        <div class="col-xs-12 col-sm-6">
                            <span class="block input-icon input-icon-right">
                        <select name="service_area" id="service_area" class="width-100" >
                            <php> $region = D(Region)->select(); </php>
                            <volist name="region" id="vo">
                            <option value="{$vo['id']}" <if condition ="$model['service_area'] eq $vo['id']"> selected </if>>{$vo['name']}</option>
                            </volist>
                        </select>
                        <i class=""></i>
                    </span>
                        </div>
                        <div class="help-block col-xs-12 col-sm-reset inline" style="margin-bottom: 5px;"></div>
                    </div>
                    <div class="form-group">
                        <label class="col-xs-12 col-sm-3 col-md-3 control-label no-padding-right" for="bussinessArr"> 业务范围 </label>
                        <div class="col-xs-12 col-sm-6">
                            <span class="block input-icon input-icon-right">
                        <div class="checkbox">
                            <php>$fundingType = D('FundingType')->select();</php>
                            <foreach name="fundingType" item="vo" >
                          <label>
                            <input type="checkbox" name="bussinessArr[]" value="{$vo['id']}">{$vo['long_name']}<br/>
                          </label>
                          </foreach>
                        </div>
                        <i class=""></i>
                    </span>
                        </div>
                        <div class="help-block col-xs-12 col-sm-reset inline" style="margin-bottom: 5px;"></div>
                    </div>
                    <div class="form-group">
                        <label class="col-xs-12 col-sm-3 col-md-3 control-label no-padding-right" for="tel"> 电话 </label>
                        <div class="col-xs-12 col-sm-6">
                            <span class="block input-icon input-icon-right">
                        <input type="text" class="width-100" placeholder="电话" id="tel" name="tel"  value="{$model['tel']|default=''}" validate-required="required:请填写电话" />
                        <i class=""></i>
                    </span>
                        </div>
                        <div class="help-block col-xs-12 col-sm-reset inline" style="margin-bottom: 5px;"></div>
                    </div>
                    <div class="form-group">
                        <label class="col-xs-12 col-sm-3 col-md-3 control-label no-padding-right" for="justification"> 营业执照 </label>
                        <div class="col-xs-12 col-sm-6">
                            <span class="block input-icon input-icon-right">
                        <input type="file" class="width-100" placeholder="营业执照" id="justification" name="justification"  value="{$model['justification']|default=''}" validate-required="required:请填写营业执照" />
                        <i class=""></i>
                    </span>
                        </div>
                        <div class="help-block col-xs-12 col-sm-reset inline" style="margin-bottom: 5px;"></div>
                    </div>
                    <div class="clearfix form-actions">
                        <div style="margin-left: 25%;">
                            <button class="btn btn-info btn-sm" type="submit">
                                <i class="icon-ok bigger-110"></i> 提交
                            </button>
                            &nbsp; &nbsp; &nbsp;
                            <button class="btn btn-sm return" type="button">
                                <i class="icon-reply bigger-110"></i> 返回
                            </button>
                        </div>
                    </div>
                </form>
            </div>
        </div>
    </div>
</div>
<include file="Public/footer" />
